Usefulness of 18F-fluorocoline PET/CT in prostate cancer patients with biochemical recurrence: Influence of PSA kinetics and hormone therapy

Abstract

Purpose: To evaluate the capacity of 18f-fluorocholine positron emission tomography/computed tomography (FCH PET/CT) to detect biochemical recurrence of prostate cancer and to determine the correlation with PSA kinetics and influence of antiandrogen hormone therapy.

Patients and methods: Observational and retrospective study, which included patients with prostate cancer and criteria for biochemical recurrence and/or resistance to castration, according to the European Association of Urology. FCH PET/CT results were classified as positive or negative, using as gold standard the pathology report, findings of other imaging test, and/or clinical follow-up results. The correlation between FCH PET/CT and PSA kinetics (PSA at the time of exploration [PSA-trigger], doubling time [PSAdt] and velocity [PSAva]) was studied and the influence of hormone therapy was analysed.

Results: The study included 203 patients. The FCH PET/CT detection rate was 43.3%. The group of patients with FCH PET/CT positive showed more aggressive PSA kinetics (PSAdt: 7.5 months and PSAva 8.37±14.8ng/ml/a) than the FCH PET/CT negative group (PSAdt: 14.5±7.6 months and PSAva: 1.8±3.7ng/ml/a). The detection rate of FCH PET/CT in the subgroup with castration resistance was 89.1%, significantly higher than in the group with radical treatment at 29.9%, p<.001.

Conclusions: FCH PET/CT is useful to detect biochemical recurrence of prostate cancer, especially in patients who receive hormone therapy or more aggressive PSA kinetics.

Keywords: 18F-fluorocholine; 18F-fluorocolina; Antiandrogenic therapy; Biochemical recurrence prostate; Cinética PSA; Cáncer de próstata; PET/CT; PET/TC; PSA Kinetics; Prostate cancer; Recidiva bioquímica; Terapia hormonal.